The nurse is caring for a patient with severe sepsis who was resuscitated with 3000 mL of lactated Ringer solution over the past 4 hours. Morning laboratory results show a hemoglobin of 8 g/dL and hematocrit of 28%
What is the best interpretation of these findings by the nurse? a. Blood transfusion with packed red blood cells is required.
b. Hemoglobin and hematocrit results indicate hemodilution.
c. Fluid resuscitation has resulted in fluid volume overload.
d. Fluid resuscitation has resulted in third spacing of fluid.
B
Fluid resuscitation with large volumes of crystalloid results in hemodilution of red blood cells and plasma proteins. Hemoglobin and hematocrit results indicate hemodilution. Given the clinical scenario, there is no evidence to support the need for a blood transfusion and no evidence of fluid overload. Although administration of large volumes of crystalloid can result in hemodilution of plasma proteins leading to third spacing of fluid, this fact does not support the hemoglobin and hematocrit results.
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The patient is 24 hours post acute myocardial infarction and may have developed a ventricular septum rupture. What nursing assessment would best indicate this complication?
A) Loud holosystolic murmur B) Dyspnea and basal crackles C) Sinus tachycardia D) Pain unrelieved by nitroglycerin
A medicine container that uses a rubber bulb to propel a spray of medication into the nose is a(n)
A. atomizer. B. metered-dose inhaler. C. steam inhaler. D. vaporizer.
It is recognized that there is limited evidence documenting the outcome of association work. Which topics have been suggested as possible research topics to explore the work or outcome of associations? (Select all that apply.)
A) What current characteristics need to be changed to ensure future success? B) How many members in professional groups were first leaders in student groups? C) What methods work best to recruit new nurses from other associations? D) What do the association executive officers see as the future for the association? E) What is a proven method to replace retiring Baby Boomers?
A nurse is caring for a patient who is addicted to alcohol and drugs and is discussing the pathway of the brain responsible for this behavior
The nurse should know that the pathway of the brain thought to be involved in pleasurable sensations and the euphoria resulting from use of drugs is called the: A) Tuberinfundibular dopamine pathway B) Nigrostriatal dopamine pathway C) Mesocortical dopamine pathway D) Mesolimbic dopamine pathway